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The 50-year clinical course of a case of osteomyelitis of the left tibia is reported. Surgical specimens were positive for Klebsiella pneumoniae allowing treatment with certriaxone and ciprofloxacine. After antibiotic therapy, regional skin expansion was possible with excision and simultaneous closure of a wide area of damaged skin resulting from the long-term infection.

Subcutaneous extravation of antimitotic agents in the upper limb is a rare complication of chemotherapy. The functional integrity of the limb can be compromised due to severe skin damage. Extensive soft tissue necrosis is difficult to manage and cannot always be repaired without sequellae. Based on an analysis of a series of patients and a review of the literature, we report the main pathophysiological features and clinical signs of such accidents as well as the still debated therapeutic management. Two points are essential: the emergency situation created by these accidents requiring adequate and rapid treatment despite the apparently benign appearance of the extravation and imperative prevention which is the main therapeutic tool.

We report our experience with 23 patients with rheumatoid arthritis who presented 48 tendon lesions involving 32 extensor tendons and 16 flexion tendons. Translocations of healthy tendons, overlapping with adjacent healthy tendons and tendon grafts were performed. Results for extensor tendons, expressed as defect in residual extension were excellent in 8 patients, good in 5 and mediocre in 4. For flexor tendons, there were 2 excellent results and 5 mediocre results in terms of thumb-palm contact. Prevention by early synovectomy is particularly important.

From 1987 to 1993, surgery combining two techniques was performed for 12 patients with uncomplicated abdominal wall eventration and excess subcutaneous adipose tissue. In order to meet both the functional and aesthetic needs of these patients, the operations required the co-operation between the plastic surgery and the abdominal surgery teams. Abdominal plasty was required to repair muscle and aponeurosis damage and remove abdominal dermolipodystropy with minimal, good quality scars. The early and late results were evaluated on the basis of several parameters including: global abdominal morphology, parietal containment, scar formation, complications, and the effect of treatment. Optimal results require a pluri-disciplinary approach.

The aim of this experimental study was to examine two new wound healing adjuvants. Four experimental wounds were created on the back of rabbits to compare the kinetics of wound healing after applying the standard treatment, Silastic gel, and elastomer with and without compounds known to act on wound healing. We observed a tendency towards more rapid healing in the gel groups (13.7 days), the elastomer group (17.3 days) and the elastomer with active compound group (15.3 days) compared with the control group (17.3 days) and the standard treatment group (17.8 days). The differences were not however statistically different. Elastomer is the better carrier for active wound healing compounds because it has better stability over time. Silicon dressings are interesting for wound healing because they give satisfactory results in terms of healing time and in terms of redressing and patient comfort.

Skin expansion is a revolutionary technique for plastic surgery. Its principle is based on the observation of clinical facts, such as pregnancy, in which the skin can readily become distended. The technique consists in implanting a silicon prosthesis, connected to a filling valve through a tube, under the skin. The inflation of this prosthesis takes 3 months. At the end of this time, good-quality skin with the same features as normal skin (color, hairs, sensation) is available. There are many indications for this technique, including substance losses, removal of congenital tumors and of scars, breast reconstruction or scalp surgery.